Coping Strategies with Stress and Its Associated Factors among Cancer Patients

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In Ethiopian patients showed lower quality of life in most dimensions, especially in financial difficulties, physical functioning, pain, and appetite loss. Therefore, this study aimed to assess coping strategies with stress and associated factors among cancer diagnosed patients at Jimma medical center. Method and material : A cross-sectional study was carried out at Jimma medical center among 422 study participants. Simple random sampling was employed to select study participants. A structured interviewer administered questionnaire was used. Bivariate analysis and multivariable logistic regression were performed to assess the association between the variables. P-value less than or equal to 0.05 was taken as cut of value to be significant. Result 53.2% of the study participants had positive coping strategy for cancer related stress. Educational level [AOR = 5.914 and 95% CI (2.344, 14.921)], social support [AOR = 3.916 and 95% CI (1.886, 8.132)], and Psychological and spiritual support [AOR = 6.453 and 95% CI (3.084, 13.503)] were positively associated with copying strategy with stress whereas, monthly income [AOR = 0.021 and 95% CI ((0.007, 0.064)] and level of pain [AOR = 0.231 and 95% CI (0.091, 0.588)] were negatively associated. Conclusion and recommendation: near to half of study participants had negative coping strategy. There was a statically significant association between coping strategy and educational level, social support, psychological and spiritual support, monthly income, and level of pain. In the future, better to take special attention on the accessibility of cancer treatment and social support in order to address the use different coping strategies. Coping strategies Cancer patients Jimma medical center Figures Figure 1 Introduction Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumors and neoplasm ( 1 ). Coping, defined as a series of responses to stressful events that are used to handle and neutralize them, is a psychological resource that is demonstrated by intervening in terms of perceived danger ( 2 ). Coping is an individual’s effort to control stress and adjust to the needs of added problems. The use of different coping mechanisms to relief the effects of stress on individual’s physical and psychological symptom ( 3 ) Cancer is a huge public health issue that affects people all over the world, and it is the second largest cause of death in the United States ( 4 ). Cancer is one of the top three causes of mortality in low-income nations, and these countries have had the greatest growth in cancer disease incidence ( 5 ). It is approximated that one-third of people being diagnosed with cancer will undergo psychological and emotional suffering at some degree during their cancer experience ( 6 ). Cancer patients are stressed with uncertainty, disease severity, physical difficulties, medical treatments, psychological state, and family issues ( 7 ). Furthermore, the worldwide cancer burden is increasing, putting enormous physical, emotional, and financial strain on individuals, families, communities, and health-care systems ( 8 ). Financial constraints and demands imposed by health-care services for cancer patients result in an earlier departure from the hospital ( 9 ). Cancer patients experienced emotional, social, and financial issues. Educational status, income, financial troubles, weariness, and insomnia were all major factors that influenced the copping strategies with cancer patients who were undergoing chemotherapy ( 10 ). African cancer patients confront particular obstacles such as poverty, lack of access to health care, and underfunded healthcare systems ( 11 ). High priority has been identified for reducing the impacts of cancer and providing high-quality treatment, including symptom management, side effect control, and social, psychological, spiritual, and emotional support ( 12 ). Inadequate coping is related with higher levels of psychological suffering. Thus, the types of coping strategies that patients use may also determine the distress that go with in cancer ( 13 ). Considering the rise in cancer patients, it is remarkable that so little empirical research on cancer patient coping techniques has been undertaken. No previous study findings have been completed, and there is an information gabs in Jimma Medical Center regarding coping techniques for cancer patients. Therefore, the main aim of this research was to assess coping strategy and its associated factors with cancer patient in Jimma medical center. Methods Study design An institutional based cross-sectional study was conducted to assess coping strategy and its associated factors with cancer patient. All cancer diagnosed patients attending Jimma Medical Center oncology unit were considered as source population while selected cancer patients using simple random sampling techniques during the study period were our study population. Participants Cancer patients who are 18 years old and above and those who were willing to participate in the study were included in the study. Patients who were seriously ill; have mental health problems; and those patients unable to communicate were excluded from the study. Sample size determination : The sample size for this study was determined using single population proportion formula by considering: confidence level of 95%, Z α/2 = 1.96; margin of error 5% (d = 0.05); and A population proportion of 50% was used due to absence previous published study in Ethiopia. The sample size was calculated as follows: n = \(\:\frac{{\left(Z{\alpha\:/}_{2}\right)}^{2}P\left(1-P\right)}{{d}^{2}}\) = \(\:\frac{{\left(1.96\right)}^{2}0.5\left(1-0.5\right)}{{\left(0.05\right)}^{2}}\) = 384. By adding 10% non-response rate total sample size were 422 Data collection instrument The valid and reliable instrument was adapted according to the research question. The data was collected by using face to face interview with structured questionnaires. The instrument has four sections. Section one is socio-demographic characteristics of patient (7-items), section two is Clinical factors (4-items), section three is Personal Factors ( 20 ), and section four is cancer coping strategies (28-items). The outcome variable of this study (Coping strategy with stress) was measured by Brief cope scale which is a 28-items self-report measure of problem focused and emotion focused coping skills ( 14 ). The participants were asked to respond to each item on a 4-point likert scale indicating what they generally do and feel when they experience cancer related stressful events (1 = I have not been doing this at all and 4-I have been doing this a lot). Data collection Procedure The questionnaire was prepared in English and translated into the local language, Afan Oromo and Amharic, and then back to English to keep its consistency. Two BSc nurses were recruited as data collectors and one BSc nurse as supervisor. Data collectors were trained for one day about objectives, data gathering methods, and questionnaires before they go to data collection. The questionnaire was pre-tested on 5% of the final sample size at Shenen Gibe general hospital one week before the actual data collection period to check consistency of the instrument. The reliability of tool was checked using cronbach alpha from pre-test result which was > 0.7. The quality of data was ensured through regular supervision, immediate feedback, and reviewing each of completed questionnaires daily was carried out by the principal investigator to maintain data quality. Those questions that aren't completed were eliminated during data input and also proper classification and coding was completed. Data analysis Following the data collection, data was coded and entered to a computer using Epidata version 4.6 and then exported to SPSS version 25.0 for analysis. Model fitness was checked by Hosmer and Lemshow test. Both descriptive and analytic analysis was performed. In the descriptive analysis, a simple frequency was calculated. In the analytic statistics, binary logistic analysis was performed to determine bivariate association between the independent variables and dependent variables. Those explanatory variables with a p value < 0.25 in crude analysis were considered as a candidate for multivariate analysis. Multivariate logistic regression analysis was used to identify factors associated with coping strategies with stress. Those variables with a p value < 0.05 in multivariate analysis were considered as significant predictor of coping strategies with stress. Ethical Consideration Ethical clearance was obtained from Institutional Review Board (IRB) of Jimma University (JU), Institute of health. A formal letter from Institute of health science was submitted to Jimma medical center (JMC) to acquire their co-operation. Ethical issues within the study were taken into consideration when carrying out the study. At the initial stage of data collection informed written consent was taken from respondents and the respondents were assured that their participation was recoded anonymously. Respondents were informed the purpose, merit, and demerits of the study and their participation were voluntary and the choice to participate or not will have no any kind of effect on them. All the data obtained in due course was kept confidentially by a paper copy of the collected data which were kept in a locked and secured location and the electronic data was kept in password protected computer. Result Socio-demographic Characteristics In this study, a total of 417 patients were interviewed as study participants with a response rate of 98.8%. From the total study participants, 269 (64.5%) were females. More than one-fourth of participants 116 (27.8%) were in the age range of 40–49 years with the mean age of 41.33 ± (SD = 12.5) years. Regarding educational status, 147 (35.3%) of respondents can’t read and write while 69 (16.5%) completed primary education. In terms of marital status, 337 (80.8%) of respondents were married. More than half, 256 (61.4%) of study participants were live in rural area. Concerning occupation, 158 (37.9%) of them were house wife, whereas 118 (28.3%) were farmer. Regarding monthly income, 206 (49.4%) of the respondents earned > 2801 ETB per month, with the mean monthly income being 3761.5 Ethiopian birr (SD ± 4749.5) (Table 1 ). Table 1 Socio-demographic characteristics cancer patients in Jimma Medical Center Southwest Ethiopia, 2024 Variable Category Frequency Percentage (%) Sex Male 148 35.5 Female 269 64.5 Age 18–29 65 15.6 30–39 111 26.6 40–49 116 27.8 50–59 66 15.8 60–69 52 12.5 > 70 7 1.7 Educational status Can’t read and write 147 35.3 Primary 69 16.5 Secondary 91 21.8 Tertiary 110 26.4 Marital status Single 44 10.6 Divorced 17 4.1 Married 337 80.8 Widowed 19 4.6 Place of residence Urban 161 38.6 Rural 256 61.4 Occupational status House wife 158 37.9 Farmer 118 28.3 Teacher 24 5.8 Student 113 27.1 Retired 16 3.8 Others 13 3.1 Monthly Income 2801 206 49.4 Description of Associated Factors From the total participants 372 (89.2%) had no co-morbid illness and 214 (51.3%) of study participants were diagnosed for cancer within > 6 month. Regarding to cancer stage most participants 177 (42.4%) were in stage IV followed by stage III which was 88 (21.1%). Concerning level of pain 183 (43.9%) of participants had moderate pain. According to social support 224 (53.7%) of study participants had no social support and 214 (51.8%) of participants had no psychological and spiritual support. Majority of study participants 363 (87.1%) were didn’t use substance and 296 (71.0%) of participants were didn’t perform physical activity (Table 2 ). Table 2 Associated factors with coping strategies among cancer patients at Jimma Medical Center, Southwest Ethiopia 2024 Variable Category Frequency Percentage (%) Co-morbid illness Yes 45 10.8 No 372 89.2 Duration since diagnosis 2 years 27 6.5 Stage of cancer Stage I 52 12.5 Stage II a 58 13.9 Stage II b 21 5.0 Stage III 88 21.1 Stage IV 177 42.4 Not known 21 5.0 Level of pain Mild 166 39.8 Moderate 183 43.9 Severe 68 16.3 Social support No 224 53.7 Yes 193 46.3 Psychological and spiritual support No 214 51.3 Yes 203 48.7 Substance use No 363 87.1 Yes 54 12.9 Activity and exercise No 296 71.0 Yes 121 29.0 Coping Strategies among Cancer Patients The result of this study showed that 222 (53.2%) of the study participants had positive coping strategy for cancer related stress as indicated by pie chart below (Fig. 1 ) Logistic Regression Analysis on Coping Strategies among Cancer Patients’ To assess the association between coping strategies and independent variables, bivariate logistic regression was conducted to identify a candidate variable. During the selection of these variables P-value < 0.25 was used as a criterion. On bivariate analysis the factors found to satisfy the minimum requirements (P-value < 0.25) were educational status, income, occupational status, residency, co-morbid illness, stage of cancer, social support, psychological and spiritual support and substance use. To determine the association between coping strategies with independent variables, multivariable logistic regression with adjusted odds ratio at a significance level of 0.05 was done. Ten variables were run in multi-variable logistic regression model by using backward regression method and 5 variables shows statistically significant association with coping strategies (p < 0.05). Level of education, level of pain, monthly income, social support, and psychological and spiritual support have been associated with out came of coping strategies with stress. Based on this, the regression analysis indicated that patient who had educated is higher than those who cannot read and write. The more the participants are educated the higher positive coping mechanisms they practice. Patients who had tertiary educational level were 5.9 times more likely to have positive coping strategy with stress than who can’t read and write [p = 0.001, AOR = 5.914 and 95% CI (2.344, 14.921)]. Patients with pain level increases the coping strategy with stress become decrease. Patients who had severe pain were 0.23 times less likely to have positive coping strategy with stress than mild pain [p = 0.002, AOR = 0.231 and 95% CI (0.091, 0.588)]. Monthly income also has significant association with coping strategy with stress. Patients who had income less than 1800 ETB were 0.02 times less likely to have positive coping strategy than income more than 2801 ETB. [p = 0.001, AOR = 0.021 and 95% CI ((0.007, 0.064)]. The study result showed that, patients who had social support were 3.9 times more likely to have positive coping strategy with stress than who had no social support [p = 0.001, AOR = 3.916 and 95% CI (1.886, 8.132)]. Another significant finding with coping strategy with stress was psychological and spiritual support. Patients who had psychological and spiritual support were 6.4 times more likely than who had no psychological and spiritual support [p = 0.001, AOR = 6.453 and 95% CI (3.084, 13.503)] (Table 3 ). Table 3 Logistic Regression Analysis on coping strategies among cancer patients’ at Jimma Medical Center, 2024 Variable Category Coping strategy COR (95% CI) AOR (95% CI) Negative N (%) Positive N (%) Educational status Can’t read and write Primary Secondary Tertiary 99 (44.6) 26 (11.7) 42 (18.9) 55 (24.8) 48 (24.6) 43 (22.1) 49 (25.1) 55 (28.2) 1 3.411 (1.878, 6.194)* 2.406 (1.406, 4.118)* 2.062 (1.240, 3.429)* 1 3.316 (1.166, 9.429)** 4.783 (1.888, 12.115)** 5.914 (2.344, 14.921)** Level of pain Mild Moderate Severe 49 (22.1) 143 (64.4) 30 (13.5) 134 (68.7) 23 (11.8) 38 (19.5) 1 0.059 (0.034, 0.102)* 0.463 (0.259, 0.827)* 1 0.012 (0.004, 0.040)** 0.231 (0.091, 0.588)** Monthly income 2801 113 (50.9) 32 (14.4) 77 (34.7) 44 (22.6) 22 (11.3) 129 (66.2) 0.232 (0.148, 0.364)* 0.410 (0.223, 0.757)* 1 0.021 (0.007, 0.064)** 0.044 (0.013, 0.150)** 1 Social support No Yes 153 (68.9) 69 (31.1) 71 (36.4) 124 (63.6) 1 3.873 (2.577, 5.819)* 1 3.916 (1.886, 8.132)** Psychological and spiritual support No Yes 154 (69.4) 68 (30.6) 60 (30.8) 135 (69.2) 1 5.096 (3.358, 7.732)* 1 6.453 (3.084, 13.503)** N = frequency, COR = crude odds ratio, AOR = adjusted odds ratio, P < 0.25=*, P < 0.05=** 1 = Reference Discussion This study showed that, the stress coping strategy for cancer patients attending Jimma Medical Center. Around 417 cancer patients were participated in the study. 53.2% of the study participants had positive coping strategy with stress. Being educated, social support and psychological and spiritual support were positively associated with coping strategy with stress, on the other hand level of pain, and monthly income were negatively associated with coping strategy with stress. The finding of this study showed that 53.2% of the study participants had positive coping strategy with stress. This study finding was in line with the study conducted in Addis Ababa which was 51.1%. Again this study finding was in line with the study conducted in Philadelphia ( 15 ). But this study finding was inconsistent with the study conducted in Australia ( 7 ). The probable explanation for this difference it might be due to differences in socio-economic status and lifestyle of the study population. This study showed that, educational status of study participants had significant association with coping strategy with stress. The more the participants are educated the higher positive coping mechanisms they practice. Patients who had tertiary educational level were 5.9 times more likely to have positive coping strategy with stress than who can’t read and write. This study finding was similar with study conducted in India, which showed that patients with no formal education had negative coping strategy ( 16 ). Similarly, study conducted in Taiwan showed patients with higher level of education had positive coping strategy than lower educational status ( 17 ). Another significant finding of this study was social support. Patients who had social support were 3.9 times more likely to have positive coping strategy with stress than who had no social support. This finding was consistence with the study conducted in Addis Ababa; patients having social support were 3.4 times more likely to have positive coping strategy with stress than their counterpart ( 18 ). Again this finding was supported by studies conducted in USA, China, and Iran ( 16 , 19 – 21 ). This may be due to those having social support might share their worries and stress with supporters and get financial support for transport, treatment and laboratory investigation. Pain level was significantly associated with coping strategy with stress. When pain level increases patient coping strategy was decrease. Patients who had severe pain were 0.23 times less likely to have positive coping strategy with stress than mild pain. This study finding was consistent with study conducted in USA, which stated, patients with lower pain had positive coping strategy ( 22 ). This study finding reveled that, psychological and spiritual support had significant association with coping strategy. Patients who had psychological and spiritual support were 6.4 times more likely than who had no psychological and spiritual support. This study finding was consistent with study conducted in Lebanon and Egypt ( 23 , 24 ). Also this study finding was supported by a study conducted in Taiwan; patient having religious activity had positive coping strategy ( 17 ). Monthly income was negatively associated with coping strategy. Patients with lower income had negative coping strategy than their counterparts. Similarly this study finding was supported by a study conducted in Indian which stated that patients with lower monthly income had negative coping strategy with stress than having high income level ( 25 ). Limitations of the study There was recall bias on some variables and also cause and effect was not measured between coping strategy with stress and its associated factors among cancer patients Conclusion This study was aimed to assess coping strategies of stress among cancer patient. Near to half of the study participants had negative copping strategies with stress. Educational level, social support, Psychological and spiritual support, monthly income, and level of pain were identified as factors associated with copying strategy with stress. Educational level, social support, and Psychological and spiritual support were positively associated with copying strategy with stress. On the other hand monthly income and level of pain were negatively associated with copying strategy with stress. Abbreviations AOR Adjusted odds ratio CI 95% Confidence interval COR Crude odds ratio ETB Ethiopian Birr IRB Institutional Review Board JIHS Jimma Institution Health Science JMC Jimma Medical Center JU Jimma University S.E Standard error SD Standard Division SPSS Statistical Package for Social Science WHO World health organization Declarations Ethics approval and consent to participate : Ethical clearance was obtained from Institutional Review Board (IRB) of Jimma University (JU). A formal letter from Institute of health science was submitted to Jimma medical center (JMC) to acquire their co-operation. Ethical issues within the study were taken into consideration when carrying out the study. The study and all associated protocols were reviewed and approved by Jimma University Institutional Review Board (IRB), Institute of Health Science, School of Nursing, under the Declaration of Helsinki (assigned approval number: JUIRB/89/24). Participants signed or thumb printed a written consent form after receiving a thorough explanation before participating in the study. During taking informed consent, I have been asked to participate in the study and I received information about what is going to be done, the risks, rights as a volunteer and the benefits involved in this research. I understand that by signing this consent form, if participants are illiterate thumb printed and I do not waive any of my legal rights nor does it relieve investigators of liability; but merely indicate that I have been informed about the research study in which I am voluntarily agreeing to participate. A copy of this form will be provided to me. The study was approved by Jimma University Institutional Review Board (IRB). Consent for publication: Not applicable Availability of data and materials: The data that support the findings of this study are available from the corresponding author upon reasonable request. Competing Interests: The authors declare no conflicts of interest. Funding: The authors would like to thank Jimma University for sponsoring this study. Authors' contributions: Getenesh Bekele Wondimagegnehu: Conceptualization, Methodology, Data curation, Formal analysis, Investigation, Writing original draft. Mihret Gashaye Yeneget: Conceptualization, Methodology, Software, Data curation, Resources, Formal analysis, Investigation, Writing original draft. Sheka Shemsi Seid : Methodology, Validation, Writing review & editing. Admasu Belay Gizaw: Conceptualization, Methodology, Writing review & editing, Validation. Finally, all authors reviewed and approved the manuscript for submission. Acknowledgements: The authors deepest thank also extended to instructors at the school of Nursing of Jimma University who supported us either directly or indirectly by giving a constructive comments and guidance. Last but not least, the authors would not wrap up without thanking our data collectors for their support and encouragement throughout this work and patients who participated in this study for their willingness to share their experiences. References Saunik S. Gender Climate in Indian Oncology and Other Sectors. Indian J Med Paediatr Oncol. 2022;43(01):008–9. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8149071","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":572763650,"identity":"6a70a438-e15f-4d69-bc02-2942b9cfde58","order_by":0,"name":"Getenesh Bekele Wondimagegnehu","email":"","orcid":"","institution":"Jimma University","correspondingAuthor":false,"prefix":"","firstName":"Getenesh","middleName":"Bekele","lastName":"Wondimagegnehu","suffix":""},{"id":572763651,"identity":"7e657dd4-5f94-4c2e-91bd-1f344c07e19f","order_by":1,"name":"Mihret Gashaye 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Gizaw","email":"","orcid":"","institution":"Jimma University","correspondingAuthor":false,"prefix":"","firstName":"Admasu","middleName":"Belay","lastName":"Gizaw","suffix":""}],"badges":[],"createdAt":"2025-11-18 21:23:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8149071/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8149071/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":100366301,"identity":"0962973e-141f-4b4f-971d-2a0e24a1bf22","added_by":"auto","created_at":"2026-01-16 07:56:12","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":17595,"visible":true,"origin":"","legend":"","description":"","filename":"ListofFigure.docx","url":"https://assets-eu.researchsquare.com/files/rs-8149071/v1/fbe1342acf966d9dbc36d881.docx"},{"id":100123105,"identity":"9536ee23-890c-4912-8488-3f42ba431fb7","added_by":"auto","created_at":"2026-01-13 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09:08:11","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":106759,"visible":true,"origin":"","legend":"","description":"","filename":"968f49c131bf46938caa9e5ba4d263d71structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8149071/v1/99f87205df3ef6ff51238716.xml"},{"id":100123082,"identity":"209a97e7-3724-4b10-80a6-36abd6f48bd5","added_by":"auto","created_at":"2026-01-13 09:08:12","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":116291,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8149071/v1/bb2e4bedf1a0aa3bd2619e35.html"},{"id":100123102,"identity":"696c6c39-7ec6-40c0-9c15-52e3d27e42c9","added_by":"auto","created_at":"2026-01-13 09:08:12","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":48552,"visible":true,"origin":"","legend":"\u003cp\u003ecoping strategy with stress among cancer patients at Jimma Medical Center, 2024\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8149071/v1/d69072d567f2300b95852f9b.jpg"},{"id":100382236,"identity":"06fdda57-3dd1-44db-bd6d-c8ccaba987b7","added_by":"auto","created_at":"2026-01-16 10:41:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":995364,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8149071/v1/9c1fb0f5-b324-43fb-b235-c5f150bd3230.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Coping Strategies with Stress and Its Associated Factors among Cancer Patients","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumors and neoplasm (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Coping, defined as a series of responses to stressful events that are used to handle and neutralize them, is a psychological resource that is demonstrated by intervening in terms of perceived danger (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Coping is an individual\u0026rsquo;s effort to control stress and adjust to the needs of added problems. The use of different coping mechanisms to relief the effects of stress on individual\u0026rsquo;s physical and psychological symptom (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eCancer is a huge public health issue that affects people all over the world, and it is the second largest cause of death in the United States (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Cancer is one of the top three causes of mortality in low-income nations, and these countries have had the greatest growth in cancer disease incidence (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). It is approximated that one-third of people being diagnosed with cancer will undergo psychological and emotional suffering at some degree during their cancer experience (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Cancer patients are stressed with uncertainty, disease severity, physical difficulties, medical treatments, psychological state, and family issues (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Furthermore, the worldwide cancer burden is increasing, putting enormous physical, emotional, and financial strain on individuals, families, communities, and health-care systems (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFinancial constraints and demands imposed by health-care services for cancer patients result in an earlier departure from the hospital (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Cancer patients experienced emotional, social, and financial issues. Educational status, income, financial troubles, weariness, and insomnia were all major factors that influenced the copping strategies with cancer patients who were undergoing chemotherapy (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). African cancer patients confront particular obstacles such as poverty, lack of access to health care, and underfunded healthcare systems (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). High priority has been identified for reducing the impacts of cancer and providing high-quality treatment, including symptom management, side effect control, and social, psychological, spiritual, and emotional support (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInadequate coping is related with higher levels of psychological suffering. Thus, the types of coping strategies that patients use may also determine the distress that go with in cancer (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Considering the rise in cancer patients, it is remarkable that so little empirical research on cancer patient coping techniques has been undertaken. No previous study findings have been completed, and there is an information gabs in Jimma Medical Center regarding coping techniques for cancer patients. Therefore, the main aim of this research was to assess coping strategy and its associated factors with cancer patient in Jimma medical center.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e \u003cstrong\u003eStudy design\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eAn institutional based cross-sectional study was conducted to assess coping strategy and its associated factors with cancer patient. All cancer diagnosed patients attending Jimma Medical Center oncology unit were considered as source population while selected cancer patients using simple random sampling techniques during the study period were our study population.\u003c/p\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eParticipants\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eCancer patients who are 18 years old and above and those who were willing to participate in the study were included in the study. Patients who were seriously ill; have mental health problems; and those patients unable to communicate were excluded from the study.\u003c/p\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eSample size determination\u003c/b\u003e: The sample size for this study was determined using single population proportion formula by considering: confidence level of 95%, Z α/2 = 1.96; margin of error 5% (d = 0.05); and A population proportion of 50% was used due to absence previous published study in Ethiopia. The sample size was calculated as follows: n = \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{{\\left(Z{\\alpha\\:/}_{2}\\right)}^{2}P\\left(1-P\\right)}{{d}^{2}}\\)\u003c/span\u003e\u003c/span\u003e= \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{{\\left(1.96\\right)}^{2}0.5\\left(1-0.5\\right)}{{\\left(0.05\\right)}^{2}}\\)\u003c/span\u003e\u003c/span\u003e= 384. By adding 10% non-response rate total sample size were 422\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eData collection instrument\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eThe valid and reliable instrument was adapted according to the research question. The data was collected by using face to face interview with structured questionnaires. The instrument has four sections. Section one is socio-demographic characteristics of patient (7-items), section two is Clinical factors (4-items), section three is Personal Factors (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), and section four is cancer coping strategies (28-items). The outcome variable of this study (Coping strategy with stress) was measured by Brief cope scale which is a 28-items self-report measure of problem focused and emotion focused coping skills (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The participants were asked to respond to each item on a 4-point likert scale indicating what they generally do and feel when they experience cancer related stressful events (1 = I have not been doing this at all and 4-I have been doing this a lot).\u003c/p\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eData collection Procedure\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eThe questionnaire was prepared in English and translated into the local language, Afan Oromo and Amharic, and then back to English to keep its consistency. Two BSc nurses were recruited as data collectors and one BSc nurse as supervisor. Data collectors were trained for one day about objectives, data gathering methods, and questionnaires before they go to data collection. The questionnaire was pre-tested on 5% of the final sample size at Shenen Gibe general hospital one week before the actual data collection period to check consistency of the instrument. The reliability of tool was checked using cronbach alpha from pre-test result which was \u0026gt; 0.7. The quality of data was ensured through regular supervision, immediate feedback, and reviewing each of completed questionnaires daily was carried out by the principal investigator to maintain data quality. Those questions that aren't completed were eliminated during data input and also proper classification and coding was completed.\u003c/p\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eData analysis\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eFollowing the data collection, data was coded and entered to a computer using Epidata version 4.6 and then exported to SPSS version 25.0 for analysis. Model fitness was checked by Hosmer and Lemshow test. Both descriptive and analytic analysis was performed. In the descriptive analysis, a simple frequency was calculated. In the analytic statistics, binary logistic analysis was performed to determine bivariate association between the independent variables and dependent variables. Those explanatory variables with a p value \u0026lt; 0.25 in crude analysis were considered as a candidate for multivariate analysis. Multivariate logistic regression analysis was used to identify factors associated with coping strategies with stress. Those variables with a p value \u0026lt; 0.05 in multivariate analysis were considered as significant predictor of coping strategies with stress.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthical Consideration\u003c/strong\u003e \u003c/p\u003e\u003cp\u003e Ethical clearance was obtained from Institutional Review Board (IRB) of Jimma University (JU), Institute of health. A formal letter from Institute of health science was submitted to Jimma medical center (JMC) to acquire their co-operation. Ethical issues within the study were taken into consideration when carrying out the study. At the initial stage of data collection informed written consent was taken from respondents and the respondents were assured that their participation was recoded anonymously. Respondents were informed the purpose, merit, and demerits of the study and their participation were voluntary and the choice to participate or not will have no any kind of effect on them. All the data obtained in due course was kept confidentially by a paper copy of the collected data which were kept in a locked and secured location and the electronic data was kept in password protected computer.\u003c/p\u003e "},{"header":"Result","content":"\u003ch2\u003eSocio-demographic Characteristics\u003c/h2\u003e\u003cp\u003eIn this study, a total of 417 patients were interviewed as study participants with a response rate of 98.8%. From the total study participants, 269 (64.5%) were females. More than one-fourth of participants 116 (27.8%) were in the age range of 40–49 years with the mean age of 41.33 ± (SD = 12.5) years. Regarding educational status, 147 (35.3%) of respondents can’t read and write while 69 (16.5%) completed primary education. In terms of marital status, 337 (80.8%) of respondents were married. More than half, 256 (61.4%) of study participants were live in rural area. Concerning occupation, 158 (37.9%) of them were house wife, whereas 118 (28.3%) were farmer. Regarding monthly income, 206 (49.4%) of the respondents earned \u0026gt; 2801 ETB per month, with the mean monthly income being 3761.5 Ethiopian birr (SD ± 4749.5) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics cancer patients in Jimma Medical Center Southwest Ethiopia, 2024\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.5\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e64.5\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18–29\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.6\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30–39\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.6\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40–49\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50–59\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60–69\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt; 70\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan’t read and write\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.3\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.5\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.4\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e337\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.6\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.6\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e256\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.4\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eOccupational status\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHouse wife\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.3\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTeacher\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.1\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.1\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMonthly Income\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt; 1800\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.6\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1801–2800\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.9\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt; 2801\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e206\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49.4\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003ch3\u003eDescription of Associated Factors\u003c/h3\u003e\u003cp\u003eFrom the total participants 372 (89.2%) had no co-morbid illness and 214 (51.3%) of study participants were diagnosed for cancer within \u0026gt; 6 month. Regarding to cancer stage most participants 177 (42.4%) were in stage IV followed by stage III which was 88 (21.1%). Concerning level of pain 183 (43.9%) of participants had moderate pain. According to social support 224 (53.7%) of study participants had no social support and 214 (51.8%) of participants had no psychological and spiritual support. Majority of study participants 363 (87.1%) were didn’t use substance and 296 (71.0%) of participants were didn’t perform physical activity (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociated factors with coping strategies among cancer patients at Jimma Medical Center, Southwest Ethiopia 2024\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCo-morbid illness\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e372\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.2\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eDuration since diagnosis\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt; 6 month\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.3\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 month- 1 year\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1–2 years\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt; 2 years\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eStage of cancer\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage I\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage II a\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.9\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage II b\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage III\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage IV\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e177\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.4\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot known\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eLevel of pain\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39.8\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.9\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.3\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSocial support\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e224\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53.7\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46.3\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePsychological and spiritual support\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.3\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e203\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48.7\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSubstance use\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e363\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87.1\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.9\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eActivity and exercise\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e296\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.0\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.0\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003ch3\u003eCoping Strategies among Cancer Patients\u003c/h3\u003e\u003cp\u003eThe result of this study showed that 222 (53.2%) of the study participants had positive coping strategy for cancer related stress as indicated by pie chart below (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003ch3\u003eLogistic Regression Analysis on Coping Strategies among Cancer Patients’\u003c/h3\u003e\u003cp\u003eTo assess the association between coping strategies and independent variables, bivariate logistic regression was conducted to identify a candidate variable. During the selection of these variables P-value \u0026lt; 0.25 was used as a criterion. On bivariate analysis the factors found to satisfy the minimum requirements (P-value \u0026lt; 0.25) were educational status, income, occupational status, residency, co-morbid illness, stage of cancer, social support, psychological and spiritual support and substance use.\u003c/p\u003e\u003cp\u003eTo determine the association between coping strategies with independent variables, multivariable logistic regression with adjusted odds ratio at a significance level of 0.05 was done. Ten variables were run in multi-variable logistic regression model by using backward regression method and 5 variables shows statistically significant association with coping strategies (p \u0026lt; 0.05). Level of education, level of pain, monthly income, social support, and psychological and spiritual support have been associated with out came of coping strategies with stress.\u003c/p\u003e\u003cp\u003eBased on this, the regression analysis indicated that patient who had educated is higher than those who cannot read and write. The more the participants are educated the higher positive coping mechanisms they practice. Patients who had tertiary educational level were 5.9 times more likely to have positive coping strategy with stress than who can’t read and write [p = 0.001, AOR = 5.914 and 95% CI (2.344, 14.921)]. Patients with pain level increases the coping strategy with stress become decrease. Patients who had severe pain were 0.23 times less likely to have positive coping strategy with stress than mild pain [p = 0.002, AOR = 0.231 and 95% CI (0.091, 0.588)].\u003c/p\u003e\u003cp\u003eMonthly income also has significant association with coping strategy with stress. Patients who had income less than 1800 ETB were 0.02 times less likely to have positive coping strategy than income more than 2801 ETB. [p = 0.001, AOR = 0.021 and 95% CI ((0.007, 0.064)]. The study result showed that, patients who had social support were 3.9 times more likely to have positive coping strategy with stress than who had no social support [p = 0.001, AOR = 3.916 and 95% CI (1.886, 8.132)]. Another significant finding with coping strategy with stress was psychological and spiritual support. Patients who had psychological and spiritual support were 6.4 times more likely than who had no psychological and spiritual support [p = 0.001, AOR = 6.453 and 95% CI (3.084, 13.503)] (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic Regression Analysis on coping strategies among cancer patients’ at Jimma Medical Center, 2024\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eCoping strategy\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR (95% CI)\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR (95% CI)\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNegative N (%)\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePositive N (%)\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan’t read and write Primary\u003c/p\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99 (44.6)\u003c/p\u003e \u003cp\u003e26 (11.7)\u003c/p\u003e \u003cp\u003e42 (18.9)\u003c/p\u003e \u003cp\u003e55 (24.8)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48 (24.6)\u003c/p\u003e \u003cp\u003e43 (22.1)\u003c/p\u003e \u003cp\u003e49 (25.1)\u003c/p\u003e \u003cp\u003e55 (28.2)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e3.411 (1.878, 6.194)*\u003c/p\u003e \u003cp\u003e2.406 (1.406, 4.118)*\u003c/p\u003e \u003cp\u003e2.062 (1.240, 3.429)*\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e3.316 (1.166, 9.429)**\u003c/p\u003e \u003cp\u003e4.783 (1.888, 12.115)**\u003c/p\u003e \u003cp\u003e5.914 (2.344, 14.921)**\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of pain\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003cp\u003eModerate\u003c/p\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (22.1)\u003c/p\u003e \u003cp\u003e143 (64.4)\u003c/p\u003e \u003cp\u003e30 (13.5)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e134 (68.7)\u003c/p\u003e \u003cp\u003e23 (11.8)\u003c/p\u003e \u003cp\u003e38 (19.5)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e0.059 (0.034, 0.102)*\u003c/p\u003e \u003cp\u003e0.463 (0.259, 0.827)*\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e0.012 (0.004, 0.040)**\u003c/p\u003e \u003cp\u003e0.231 (0.091, 0.588)**\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly income\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt; 1800\u003c/p\u003e \u003cp\u003e1801–2800\u003c/p\u003e \u003cp\u003e\u0026gt; 2801\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e113 (50.9)\u003c/p\u003e \u003cp\u003e32 (14.4)\u003c/p\u003e \u003cp\u003e77 (34.7)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (22.6)\u003c/p\u003e \u003cp\u003e22 (11.3)\u003c/p\u003e \u003cp\u003e129 (66.2)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.232 (0.148, 0.364)*\u003c/p\u003e \u003cp\u003e0.410 (0.223, 0.757)*\u003c/p\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.021 (0.007, 0.064)**\u003c/p\u003e \u003cp\u003e0.044 (0.013, 0.150)**\u003c/p\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial support\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e153 (68.9)\u003c/p\u003e \u003cp\u003e69 (31.1)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71 (36.4)\u003c/p\u003e \u003cp\u003e124 (63.6)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e3.873 (2.577, 5.819)*\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e3.916 (1.886, 8.132)**\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychological and spiritual support\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e154 (69.4)\u003c/p\u003e \u003cp\u003e68 (30.6)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60 (30.8)\u003c/p\u003e \u003cp\u003e135 (69.2)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e5.096 (3.358, 7.732)*\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e6.453 (3.084, 13.503)**\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003ch2\u003eN = frequency, COR = crude odds ratio, AOR = adjusted odds ratio, P \u0026lt; 0.25=*, P \u0026lt; 0.05=** 1 = Reference\u003c/h2\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study showed that, the stress coping strategy for cancer patients attending Jimma Medical Center. Around 417 cancer patients were participated in the study. 53.2% of the study participants had positive coping strategy with stress. Being educated, social support and psychological and spiritual support were positively associated with coping strategy with stress, on the other hand level of pain, and monthly income were negatively associated with coping strategy with stress.\u003c/p\u003e \u003cp\u003eThe finding of this study showed that 53.2% of the study participants had positive coping strategy with stress. This study finding was in line with the study conducted in Addis Ababa which was 51.1%. Again this study finding was in line with the study conducted in Philadelphia (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). But this study finding was inconsistent with the study conducted in Australia (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). The probable explanation for this difference it might be due to differences in socio-economic status and lifestyle of the study population.\u003c/p\u003e \u003cp\u003eThis study showed that, educational status of study participants had significant association with coping strategy with stress. The more the participants are educated the higher positive coping mechanisms they practice. Patients who had tertiary educational level were 5.9 times more likely to have positive coping strategy with stress than who can\u0026rsquo;t read and write. This study finding was similar with study conducted in India, which showed that patients with no formal education had negative coping strategy (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Similarly, study conducted in Taiwan showed patients with higher level of education had positive coping strategy than lower educational status (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnother significant finding of this study was social support. Patients who had social support were 3.9 times more likely to have positive coping strategy with stress than who had no social support. This finding was consistence with the study conducted in Addis Ababa; patients having social support were 3.4 times more likely to have positive coping strategy with stress than their counterpart (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Again this finding was supported by studies conducted in USA, China, and Iran (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). This may be due to those having social support might share their worries and stress with supporters and get financial support for transport, treatment and laboratory investigation.\u003c/p\u003e \u003cp\u003ePain level was significantly associated with coping strategy with stress. When pain level increases patient coping strategy was decrease. Patients who had severe pain were 0.23 times less likely to have positive coping strategy with stress than mild pain. This study finding was consistent with study conducted in USA, which stated, patients with lower pain had positive coping strategy (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study finding reveled that, psychological and spiritual support had significant association with coping strategy. Patients who had psychological and spiritual support were 6.4 times more likely than who had no psychological and spiritual support. This study finding was consistent with study conducted in Lebanon and Egypt (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Also this study finding was supported by a study conducted in Taiwan; patient having religious activity had positive coping strategy (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMonthly income was negatively associated with coping strategy. Patients with lower income had negative coping strategy than their counterparts. Similarly this study finding was supported by a study conducted in Indian which stated that patients with lower monthly income had negative coping strategy with stress than having high income level (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eLimitations of the study\u003c/h3\u003e\n\u003cp\u003eThere was recall bias on some variables and also cause and effect was not measured between coping strategy with stress and its associated factors among cancer patients\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study was aimed to assess coping strategies of stress among cancer patient. Near to half of the study participants had negative copping strategies with stress. Educational level, social support, Psychological and spiritual support, monthly income, and level of pain were identified as factors associated with copying strategy with stress. Educational level, social support, and Psychological and spiritual support were positively associated with copying strategy with stress. On the other hand monthly income and level of pain were negatively associated with copying strategy with stress.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAOR \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Adjusted odds ratio\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCI \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 95% Confidence interval\u003c/p\u003e\n\u003cp\u003eCOR \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Crude odds ratio\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eETB \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Ethiopian Birr\u003c/p\u003e\n\u003cp\u003eIRB \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Institutional Review Board\u003c/p\u003e\n\u003cp\u003eJIHS \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Jimma Institution Health Science\u003c/p\u003e\n\u003cp\u003eJMC \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Jimma Medical Center\u003c/p\u003e\n\u003cp\u003eJU \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Jimma University\u003c/p\u003e\n\u003cp\u003eS.E \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Standard error\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSD \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Standard Division\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSPSS \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Statistical Package for Social Science\u003c/p\u003e\n\u003cp\u003eWHO \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; World health organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eEthical clearance was obtained from Institutional Review Board (IRB) of Jimma University (JU). A formal letter from Institute of health science was submitted to Jimma medical center (JMC) to acquire their co-operation. Ethical issues within the study were taken into consideration when carrying out the study. The study and all associated protocols were reviewed and approved by Jimma University Institutional Review Board (IRB), Institute of Health Science, School of Nursing, under the Declaration of Helsinki (assigned approval number: JUIRB/89/24). Participants signed or thumb printed a written consent form after receiving a thorough explanation before participating in the study.\u0026nbsp;During taking informed consent, I have been asked to participate in the study and I received information about what is going to be done, the risks, rights as a volunteer and the benefits involved in this research. I understand that by signing this consent form, if participants are illiterate thumb printed and I do not waive any of my legal rights nor does it relieve investigators of liability; but merely indicate that I have been informed about the research study in which I am voluntarily agreeing to participate. A copy of this form will be provided to me. The study was approved by Jimma University Institutional Review Board (IRB).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u0026nbsp;\u003c/strong\u003eThe authors declare no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThe authors would like to thank Jimma University for sponsoring this study. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e \u003cstrong\u003eGetenesh Bekele Wondimagegnehu:\u0026nbsp;\u003c/strong\u003eConceptualization, Methodology, Data curation, Formal analysis, Investigation, Writing original draft. \u003cstrong\u003eMihret Gashaye Yeneget:\u003c/strong\u003e Conceptualization, Methodology, Software, Data curation, Resources, Formal analysis, Investigation, Writing original draft.\u0026nbsp;\u003cstrong\u003eSheka Shemsi Seid\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Methodology, Validation, Writing review \u0026amp; editing. \u003cstrong\u003eAdmasu Belay Gizaw:\u003c/strong\u003e Conceptualization, Methodology, Writing review \u0026amp; editing, Validation. Finally, all authors reviewed and approved the manuscript for submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e The authors deepest thank also extended to instructors at the school of Nursing of Jimma University who supported us either directly or indirectly by giving a constructive comments and guidance. Last but not least, the authors would not wrap up without thanking our data collectors for their support and encouragement throughout this work and patients who participated in this study for their willingness to share their experiences.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSaunik S. Gender Climate in Indian Oncology and Other Sectors. Indian J Med Paediatr Oncol. 2022;43(01):008\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHidalgo-Troya A, Pantoja-C\u0026oacute;rdoba A, Sa\u0026ntilde;udo-V\u0026eacute;lez P, Rocha-Buelvas A. Coping and quality of life in oncologic patients of the province of Nari\u0026ntilde;o, Colombia. Rev Fac Med. 2016;64(2):181\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKuo TT, Ma FC. Symptom distresses and coping strategies in patients with non-small cell lung cancer. Cancer Nurs. 2002;25(4):309\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbegaz TM, Ayele AA, Gebresillassie BM. Health related quality of life of cancer patients in Ethiopia. J Oncol. 2018;2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMasika GM, Wettergren L, Kohi TW, von Essen L. Health-related quality of life and needs of care and support of adult Tanzanians with cancer: a mixed-methods study. Health Qual Life Outcomes. 2012;10(1):1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLashbrook MP, Valery PC, Knott V, Kirshbaum MN, Bernardes CM. Coping strategies used by breast, prostate, and colorectal cancer survivors: a literature review. Cancer Nurs. 2018;41(5):E23\u0026ndash;39.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarre PV, Padmaja G, Rana S, Tiamongla. Stress and quality of life in cancer patients: medical and psychological intervention. Indian J Psychol Med. 2018;40(3):232\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMOHE. Fed Ministry Health ethipia. 2020;84(9):936\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkaru AO, Rullmann A, Farah A, Gonzalez de Mejia E, Stern MC, Lachenmeier DW. Comparative oesophageal cancer risk assessment of hot beverage consumption (coffee, mate and tea): the margin of exposure of PAH vs very hot temperatures. BMC Cancer. 2018;18(1):1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHassen AM, Taye G, Gizaw M, Hussien FM. Quality of life and associated factors among patients with breast cancer under chemotherapy at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. PLoS ONE. 2019;14(9):e0222629.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan Rensburg JJJ, Maree JE, Casteleijn D. An investigation into the quality of life of cancer patients in South Africa. Asia-Pac J Oncol Nurs. 2017;4(4):336\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHolland JC. American Cancer Society Award lecture. Psychological care of patients: psycho-oncology\u0026rsquo;s contribution. J Clin Oncol Off J Am Soc Clin Oncol. 2003;21(23 Suppl):s253\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYulitasari BI, Amatayakul A, Karuncharerernpanit S. The relationship between perceived health status, activity of daily living, coping strategies, religiosity, and stress in the elderly at a public nursing home in Yogyakarta, Indonesia. J Health Res. 2015;29(Suppl 1):S97\u0026ndash;101.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJones FME, Fellows JL, de Horne DJ. Coping with cancer: a brief report on stress and coping strategies in medical students dealing with cancer patients. Psychooncology. 2011;20(2):219\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBean G, Cooper S, Alpert R, Kipnis D. Coping mechanisms of cancer patients: A study of 33 patients receiving chemotherapy. CA Cancer J Clin. 1980;30(5):256\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eColeman EA, Tulman L, Samarel N, Wilmoth MC, Rickel L, Rickel M et al. The effect of telephone social support and education on adaptation to breast cancer during the year following diagnosis. In: Oncology nursing forum. 2005.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKuo TT, Ma FC. Symptom distresses and coping strategies in patients with non-small cell lung cancer. Cancer Nurs. 2002;25(4):309\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKelkil BA, Atnafu NT, Dinegde NG, Wassie M. Coping strategies of stress and its associated factors among breast cancer patients in Tikur Anbesa specialized hospital, Ethiopia: Institution-based cross-sectional study. BMC Womens Health. 2022;22(1):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim J, Han JY, Shaw B, McTavish F, Gustafson D. The roles of social support and coping strategies in predicting breast cancer patients\u0026rsquo; emotional well-being: testing mediation and moderation models. J Health Psychol. 2010;15(4):543\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkati-Aliabad H, Ansari-Moghadam A, Mohammadi M, Kargar S, Shahraki-Sanavi F. The prevalence of anxiety and depression and its association with coping strategies, supportive care needs, and social support among women with breast cancer. Support Care Cancer. 2022;30(1):703\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoon TJ, Chih MY, Shah DV, Yoo W, Gustafson DH. Breast cancer survivors\u0026rsquo; contribution to psychosocial adjustment of newly diagnosed breast cancer patients in a computer-mediated social support group. J Mass Commun Q. 2017;94(2):486\u0026ndash;514.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReddick BK, Nanda JP, Campbell L, Ryman DG, Gaston-Johansson F. Examining the influence of coping with pain on depression, anxiety, and fatigue among women with breast cancer. J Psychosoc Oncol. 2005;23(2\u0026ndash;3):137\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMukwato KP, Mweemba P, Makukula MK, Makoleka MM. Stress and coping mechanisms among breast cancer patients and family caregivers: A review of literature. Med J Zambia. 2010;37(1):40\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eElsheshtawy EA, Abo-Elez WF, Ashour HS, Farouk O, zaafarany MIEE. Coping strategies in Egyptian ladies with breast cancer. Breast Cancer Basic Clin Res. 2014;8:BCBCR\u0026ndash;S14755.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBeattie TS, Prakash R, Mazzuca A, Kelly L, Javalkar P, Raghavendra T, et al. Prevalence and correlates of psychological distress among 13\u0026ndash;14 year old adolescent girls in North Karnataka, South India: a cross-sectional study. BMC Public Health. 2019;19(1):1\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcan","sideBox":"Learn more about [BMC Cancer](http://bmccancer.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcan/default.aspx","title":"BMC Cancer","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Coping, strategies, Cancer, patients, Jimma medical center","lastPublishedDoi":"10.21203/rs.3.rs-8149071/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8149071/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCancer is a huge public health issue that affects people all over the world and it is one of the top three causes of mortality in low-income nations. In Ethiopian patients showed lower quality of life in most dimensions, especially in financial difficulties, physical functioning, pain, and appetite loss. Therefore, this study aimed to assess coping strategies with stress and associated factors among cancer diagnosed patients at Jimma medical center.\u003c/p\u003e\u003ch2\u003eMethod and material\u003c/h2\u003e \u003cp\u003e: A cross-sectional study was carried out at Jimma medical center among 422 study participants. Simple random sampling was employed to select study participants. A structured interviewer administered questionnaire was used. Bivariate analysis and multivariable logistic regression were performed to assess the association between the variables. P-value less than or equal to 0.05 was taken as cut of value to be significant.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003e53.2% of the study participants had positive coping strategy for cancer related stress. Educational level [AOR\u0026thinsp;=\u0026thinsp;5.914 and 95% CI (2.344, 14.921)], social support [AOR\u0026thinsp;=\u0026thinsp;3.916 and 95% CI (1.886, 8.132)], and Psychological and spiritual support [AOR\u0026thinsp;=\u0026thinsp;6.453 and 95% CI (3.084, 13.503)] were positively associated with copying strategy with stress whereas, monthly income [AOR\u0026thinsp;=\u0026thinsp;0.021 and 95% CI ((0.007, 0.064)] and level of pain [AOR\u0026thinsp;=\u0026thinsp;0.231 and 95% CI (0.091, 0.588)] were negatively associated.\u003c/p\u003e\u003ch2\u003eConclusion and recommendation:\u003c/h2\u003e \u003cp\u003enear to half of study participants had negative coping strategy. There was a statically significant association between coping strategy and educational level, social support, psychological and spiritual support, monthly income, and level of pain. In the future, better to take special attention on the accessibility of cancer treatment and social support in order to address the use different coping strategies.\u003c/p\u003e","manuscriptTitle":"Coping Strategies with Stress and Its Associated Factors among Cancer Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-13 09:08:02","doi":"10.21203/rs.3.rs-8149071/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-01-26T12:20:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"96098982750644903450917315941249311530","date":"2026-01-16T15:19:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"243594020993841143622067511928446272366","date":"2026-01-16T09:43:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"48248681086560554692734404626595042577","date":"2026-01-08T06:09:23+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-08T05:30:49+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-16T19:42:30+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-15T12:28:05+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-11T21:18:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cancer","date":"2025-12-11T21:12:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcan","sideBox":"Learn more about [BMC Cancer](http://bmccancer.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcan/default.aspx","title":"BMC Cancer","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fd12fb0b-aec6-4e9e-9355-5bc0a8713ed4","owner":[],"postedDate":"January 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-13T09:08:03+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-13 09:08:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8149071","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8149071","identity":"rs-8149071","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}